The First Circuit Court of Appeals declined to rule on a question of whether qualified immunity is categorically unavailable to private medical contractors because disputed issues of material fact remained in the case.

Before the appellate court was the interlocutory appeal of a Maine federal district court’s denial of summary judgment based on qualified immunity. The First Circuit noted it had jurisdiction only to the extent the appeal rested on legal rather than factual grounds.

The defendants were employees of Corizon, a private contractor that provided medical services to prisoners at the Cumberland County Jail. The civil rights action was filed by the estate of Paul Victor Galambos III, who died on December 12, 2008 as a result of the defendants’ deliberate indifference to his serious medical needs after he injured himself and was placed in a restraint chair.

The defendants – psychiatric nurse practitioner Michael Trueworthy, Registered Nurse Barbara Walsh and Licensed Clinical Social Worker Linda Williams – argued their performance did not fall so far below the standard of care as to constitute deliberate indifference, and they were thus entitled to qualified immunity. The district court expressed doubt that the defendants, as employees of a private company performing governmental functions, would be entitled to a qualified immunity defense.

However, the court did not reach that question due to genuine issues of disputed facts in the case. Galambos had an extensive history of mental illness and substance abuse that was known to the defendants, and the complaint alleged he went into a “rapid regression in December 2008” that led to self-destructive and suicidal behavior.

Trueworthy, the district court found, could be held liable for “the decision to order a stop to the offering of prescribed [psychotropic] medications on December 1.” Walsh was directly involved in Galambos’ care, and his naked “swan dive” from a table in his cell on December 8 “deserved an emergency response” or “demonstrated a need to change the permissive approach to Galambos’ refusal to take his medication,” the court wrote. The fact that Galambos was not sent to an emergency room on December 8 was likely because he had been sent to a hospital about a week earlier after stabbing himself in the neck with a pencil. Finally, the placement of Galambos in a restraint chair when he had broken ribs could be viewed as deliberate indifference to his medical needs.

While Williams may have taken affirmative steps at “each new stage of Galambos’s slide into psychosis,” the court expressed concern as to “the nature of her response” based on all the facts in the case. As the adequacy of the defendants’ actions was disputed, a jury must resolve that dispute.

Accordingly, the First Circuit dismissed the appeal for lack of jurisdiction as it only had authority to rule on the legal issue of qualified immunity and could not resolve factual disputes. See: Cady v. Walsh, 753 F.3d 348 (1st Cir. 2014).

Following remand, the case was scheduled for trial but settled in October 2014 under confidential terms.